Parents with BP were recruited through advertisement (53.0%), adult BP studies (31.0%), and outpatient clinics (16.0%). There were no differences in BP subtype, age at BP onset, or rates of non-BP disorders on the basis of recruitment source. Parents were required to fulfill DSM-IV17 criteria for BP-I or BP-II. Exclusion criteria included current or lifetime diagnoses of schizophrenia, mental retardation, mood disorders secondary to substance abuse, medical conditions, or medication use, and living more than 200 miles away from Pittsburgh, Pennsylvania.
Control parents consisted of healthy parents or parents with non-BP psychiatric disorders from the community and were group matched by age, sex, and neighborhood using the area code and the first 3 digits of the telephone number and the zip code of the parents with BP. The exclusion criteria for the control parents were the same as those for the parents with BP, with the additional requirements that neither of the biological parents could have BP and they could not have a first-degree relative with BP. Control parents were recruited by the University Center for Social and Urban Research, University of Pittsburgh in an approximate ratio of 1 control parent for every 2 parents with BP.
With the exception of children who were unable to participate (eg, those diagnosed with mental retardation), all offspring aged 6 to 18 years from each family were included in the study.